Skip to main content
×
×
Home

Excess mortality of mental disorder

  • Clare Harris (a1) and Brian Barraclough (a1)
Abstract
Background

We describe the increased risk of premature death from natural and from unnatural causes for the common mental disorders.

Method

With a Medline search (1966–1995) we found 152 English language reports on the mortality of mental disorder which met our inclusion criteria. From these reports, covering 27 mental disorder categories and eight treatment categories, we calculated standardised mortality ratios (SMRs) and 95% confidence intervals (CIs) for all causes of death, all natural causes and all unnatural causes; and for most, SMRs for suicide, other violent causes and specific natural causes.

Results

Highest risks of premature death, from both natural and unnatural causes, are for substance abuse and eating disorders. Risk of death from unnatural causes is especially high for the functional disorders, particularly schizophrenia and major depression. Deaths from natural causes are markedly increased for organic mental disorders, mental retardation and epilepsy.

Conclusion

All mental disorders have an increased risk of premature death.

Copyright
Corresponding author
Dr B. M. Barraclough, Mental Health Group, University of Southampton, Royal South Hants Hospital, Brintons Terrace, Southampton SO14 0YG. e-mail: bhb2@soton.ac.uk Offprints will not be available from the authors.
References
Hide All
Adelstetn, A. & White, G. (1976) Alcoholism and mortality. Population Trends, 6,. 713.
Allebeck, P. (1989) Schizophrenia: a life-shortening disease. Schizophrenia Bulletin, 15, 8189.
Allgulander, C. (1994) Suicide and mortality patterns in anxiety neurosis and depressive neurosis. Archives of General Psychiatry, 51, 708712.
Amaddeo, F. Bisoffi, G. Bonizzato, P. et al (1995) Mortality among patients with psychiatric illness. A ten-year case register study in an area with a community-based system of care. British Journal of Psychiatry, 166, 783788.
Amdur, M. A. & Souchek, J. (1981) Death in aftercare. Comprehensive Psychiatry, 22, 619626.
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn. revised) (DSM—III—R). Washington. DC: American Psychiatric Association.
Anderson, C. Connelly, J. Johnstone, E. C. et al (1991) Disabilities and circumstances of schizophrenic patients — a follow-up study. V: Cause of death. British Journal of Psychiatry, 159 (suppl. 13). 3033.
Andréasson, S. Allebeck, P. & Romelsjo, A. (1988) Alcohol and mortality among young men: longitudinal study of Swedish conscripts. British Medical Journal, 296, 10211025.
Astrup, C. Fossum, A. & Holmboe, R. (1959) A follow-up study of 270 patients with acute affective psychoses. Acta Psychiatrica et Neurologica Scandinavica, 34 (suppl. 135). 165.
Babigian, H. M. & Odoroff, C. L. (1969) The mortality experience of a population with psychiatric illness. American Journal of Psychiatry, 126, 470480.
Balrd, P. A. & Sadovnick, A. D. (1988) Causes of death to age 30 in Down syndrome. American Journal of Human Genetics, 43, 239248.
Balarajan, R. Donnan, S. P. B. & Adeistein, A. M. (1982) Mortality and cause of death in Down's syndrome. Journal of Epidemiology and Community Health, 36, 127129.
Balestrieri, M. Micciolo, R. & Tansella, M. (1987) Long-stay and long-term psychiatric patients in an area with a community-based system of care. A register follow-up study. Internatioal Journal of Social Psychiatry, 33, 251262.
Barr, H. L. Antes, D. Ortenberg, D. J. et al (1984) Mortality of treated alcoholics and drug addicts: the benefits of abstinence. Journal of Studies onAlcohol, 45, 440452.
Barraclough, B. M. & Noyes, R. (1989) Language of publication of journal articles on suicide and mental disorders. Acta Psychiatrica Scandinavica, 79, 245247.
Baxter, D. N. (1996) The mortality experience of individuals on the Salford psychiatric case register. I: All-cause mortality. British Journal of Psychiatry, 168, 772779.
Benson, G. & Holmberg, M. B. (1984) Drug-related mortality in young people. Acta Psychiatrica Scandinavica, 70, 525534.
Berglund, M. (1984) Mortality in alcoholics related to clinical state at first admission. A study of 537 deaths. Acta Psychiatrica Scandinavica, 70, 407416.
Berglund, M. & Nilsson, K. (1987) Mortality in severe depression. A prospective study including 103 suicides. Acta Psychiatrica Scandinavica, 76, 372380.
Berglund, M. & Tunving, K. (1985) Assaultive alcoholics 20 years later. Acta Psychiatrica Scandinavica, 71, 141147.
Berren, M. R. Hill, K. R. Merikle, E. et al (1994) Serious mental illness and mortality rates. Hospital and Community Psychiatry, 45, 604605.
Bewley, T. H. Ben-Arie, O. & Pierce James, I. (1968) Morbidity and mortality from heroin dependence. I: Survey of heroin addicts known to Home Office. British Medical Journal, 1, 725726.
Black, D. W. Warrack, G. & Winokur, G. (1985a) The Iowa record-linkage study. II: Excess mortality among patients with organic mental disorders. Archives of General Psychiatry, 42, 7881.
Black, D. W. Warrack, G. & Winokur, G. (1985b) Excess mortality among psychiatric patients. The Iowa record-linkage study. Journal of the American Medical Association, 253, 5861.
Black, D. W. Warrack, G. & Winokur, G. (1985c) The Iowa record-linkage study. III: Excess mortality among patients with ‘functional’ disorders. Archives of General Psychiatry, 42, 8288.
Black, D. W. Winokur, G. & Nasrallah, A. (1987) Is death from natural causes still excessive in psychiatric patients? A follow-up of 1593 patients with major affective disorder. Journal of Nervous and Mental Disease, 175, 674680.
W, Black, D. & Fisher, R. (1992) Mortality in DSM-III-R schizophrenia. Schizophrenia Research, 7, 109116.
Bland, R. C. & Orn, H. (1978) 14-year outcome in early schizophrenia. Acta Psychiatrica Scandinavica, 58, 327338.
Bland, R. C. & Parker, J. H. (1976) Prognosis in schizophrenia: a ten-year follow-up of first admissions. Archives of General Psychiatry, 33, 949954.
Boffetta, P. & Garfinkel, L. (1990) Alcohol drinking and mortality among men enrolled in an American cancer society prospective study. Epidemiology, 1, 342348.
Bratfos, O. (1971) Attempted suicide: a comparative study of patients who have attempted suicide and psychiatric patients in general. Acta Psychiatrica Scandinavica, 47, 3856.
Bratfos, O. & Haug, J. O. (1968) The course of manic-depressive psychosis: a follow up investigation of 215 patients. Acta Psychiatrica Scandinavica, 44, 89112.
Brenner, B. (1967) Alcoholism and fatal accidents. Quarterly Journal of Studies on Alcohol, 28, 517528.
Buchholtz-Hansen, P. E. Wang, A. G. Kragh-Sorensen, P. et al (1993) Mortality in major affective disorder: relationship to subtype of depression. Acta Psychiatrica Scandinavica, 87, 329335.
Bucknall, A. B. V. & Robertson, J. R. (1986) Deaths of heroin users in a general practice population. Journal of the Royal College of General Practitioners, 36, 120122.
Buda, M. Tsuang, M. T. & Fleming, J. A. (1988) Causes of death in DSM—III schizophrenics and other psychotics (atypical group). A comparison with the general population. Archives of General Psychiatry, 45, 283285.
Chalmers, I. Dickersin, K. & Chalmers, T. C. (1992) Getting to grips with Archie Cochrane's agenda: all randomised controlled trials should be registered and reported. British Medical Journal, 305, 786788.
Cockerell, O. C. Johnson, A. L. Sander, J. W. A. S. et al (1994) Mortality from epilepsy: results from a prospective population-based study. Lancet, 344, 918921.
Coppen, A. Standish Barry, H. Bailey, J. et al (1991) Does lithium reduce the mortality of recurrent mood disorders. Journal of Affective Disorders, 23, 17.
Corten, P. Ribourdoullle, M. & Dramaix, M. (1991) Premature death among outpatients at a community mental health center. Hospital and Community Psychiatry, 42, 12481251.
Coryell, W. (1981) Diagnosis-specific mortality: primary unipolar depression and Briquet's syndrome (somatization disorder). Archives of General Psychiatry, 38, 939942.
Coryell, W. Noyes, R. & Clancy, J. (1982) Excess mortality in panic disorder: a comparison with primary unipolar depression. Archives of General Psychiatry, 39, 701703.
Coryell, W. & House, D. (1984) The validity of broadly defined hysteria and DSM-III conversion disorder: outcome, family history, and mortality. Journal of Clinical Psychiatry, 45, 252256.
Crisp, A. H. Callender, J. S. Halek, C. et al (1992) Long-term mortality in anorexia nervosa: a 20-year follow-up of the St George's and Aberdeen cohorts. British Journal of Psychiatry, 161, 104107.
Dahlgren, K. G. (1951) On death-rates and causes of death in alcohol addicts. Acta Psychiatrica et Neurologica Scandinavica, 24, 297311.
Dahlgren, L. (1979) Female alcoholics IV. Marital situation and husbands. Acta Psychiatrica Scandinavica, 59, 5969.
Dahlgren, L. & Myrhed, M. (1977) Alcoholic females II. Causes of death with reference to sex difference. Acta Psychiatrica Scandinavica, 56, 8191.
de Château, P. (1990) Mortality and aggressiveness in a 30-year follow-up study in child guidance clinics in Stockholm. Acta Psychiatrica Scandinavica, 81, 472476.
de Lint, J. & Levinson, T. (1975) Mortality among patients treated for alcoholism: a 5-year follow-up. Canadian Medical Association Journal, 113, 385387.
Deter, H. & Herzog, W. (1994) Anorexia nervosa in a long-term perspective: results of the Heidelberg-Mannheim study. Psychosomatic Medicine, 56, 2027.
Dimitrijevic, P. Jacobsson, L. & Wall, S. (1984) Mortality among patients suffering from organic psychoses. Nordisk Psykiatrisk Tidsskrift, 38, 127133.
Doll, R. Peto, R. Wheathley, K. et al (1994) Mortality in relation to smoking: 40 years' observations on male British doctors. British Medical Journal, 309, 901911.
Eastwood, M. R. Stiasny, S. Meier, H. M. R. et al (1982) Mental illness and mortality. Comprehensive Psychiatry, 23, 377385.
Eckert, E. D. Halmi, K. A. Marchi, P. et al (1995) Ten-year follow-up of anorexia nervosa: clinical course and outcome. Psychological Medicine, 25, 143156.
Ekeberg, O. Ellingsen, O. & Jacobsen, D. (1991) Suicide and other causes of death in a five-year follow-up of patients treated for self-poisoning in Oslo. Acta Psychiatrica Scandinavica, 83, 432437.
Engström, A. Adamsson, C. Allebeck, P. et al (1991) Mortality in patients with substance abuse: a follow-up in Stockholm County, 1973–1984. International Journal of the Addictions, 26, 91106.
Eskild, A. Magnus, P. Samuelsen, S. O. et al (1993) Differences in mortality rates and causes of death between HIV positive and HIV negative intravenous drug users. International Journal of Epidemiology, 22, 315320.
Ettlinger, R. (1975) Evaluation of suicide prevention after attempted suicide. Acta Psychiatrica Scandinavica Supplementum, 260, 1135.
Evans, N. J. R. Baldwin, J. A. & Gath, D. (1974) The incidence of cancer among in-patients with affective disorders. British Journal of Psychiatry, 124, 518525.
Evans, N. J. R. & Whitlock, F. A. (1983) Mortality and late-onset affective disorder. Journal of Affective Disorders, 5, 297304.
Gardner, M. J. & Altman, D. G. (1989) Statistics With Confidence. London: BMJ.
Giel, R. Dijk, S. & van Weerden Dijkstra, J. R. (1978) Mortality in the long-stay population of all Dutch mental hospitals. Acta Psychiatrica Scandinavica, 57, 361368.
Gillis, L. S. (1969) The mortality rate and causes of death of treated chronic alcoholics. South African Medical Journal, 43, 230232.
Goldacre, M. & Hawton, K. (1985) Repetition of self-poisoning and subsequent death in adolescents who take overdoses. British Journal of Psychiatry, 146, 395398.
Grönbladh, L. Ohlund, L. S. & Gunne, L. M. (1990) Mortality in heroin addiction: impact of methadone treatment. Acta Psychiatrica Scandinavica, 82, 223227.
Haastrup, S. & Jensen, P. W. (1984) Seven year follow-up of 300 young drug abusers. Acta Psychiatrica Scandinavica, 70, 503509.
Harris, E. C. & Barraclough, B. M. (1994) Suicide as an outcome for medical disorders. Medicine, 73, 281296.
Harris, E. C. & Barraclough, B. M. (1997) Suicide as an outcome for mental disorders. A meta-analysis. British Journal of Psychiatry, 170, 205228.
Harvey, I. Peters, T. J. & Toth, B. (1993) Meta-analysis (letter). Lancet, 341, 964.
Haugland, G. Craig, T. J. Goodman, A. B. et al (1983) Mortality in the era of deinstitutionalization. American Journal of Psychiatry, 140, 848852.
Hauser, W. A. Annegers, J. F. & Elveback, L. R. (1980) Mortality in patients with epilepsy. Epilepsia, 21, 399412.
Helgason, L. (1977) Psychiatric services and mental illness in Iceland. Incidence study (1966–67) with 6–7 year follow up. Acta Psychiatrica Scandinavica Supplementum, 268, 1140.
Helgason, L. (1977) (1990) Twenty years' follow-up of first psychiatric presentation for schizophrenia: what could have been prevented? Acta Psychiatrica Scandinavica, 81, 231235.
Herrman, H. E. Baldwin, J. A. & Christie, D. (1983) A record-linkage study of mortality and general hospital discharge in patients diagnosed as schizophrenic. Psychological Medicine, 13, 581593.
Hewer, W. Rössler, W. Fätkenheuer, B. et al (1995) Mortality among patients in psychiatric hospitals in Germany. Acta Psychiatrica Scandinavica, 91, 174179.
Heyman, A. Wilkinson, W. E. Hurwltz, B. J. et al (1987) Early-onset Alzheimer's disease: clinical predictors of institutionalization and death. Neurology, 37, 980984.
Higuchi, S. (1987) Mortality of Japanese female alcoholics: a comparative study with male cases. Japanese Journal of Alcohol and Drug Dependence, 22, 211223.
Innes, G. & Millar, W. M. (1970) Mortality among psychiatric patients. Scottish Medical Journal, 15, 143148.
James, I. P. (1967) Suicide and mortality amongst heroin addicts in Britain. British Journal of the Addictions, 62, 391398.
Johnson, R. H. & Robinson, B. J. (1988) Mortality in alcoholics with autonomic neuropathy. Journal of Neurology, Neurosurgery and Psychiatry, 51, 476480.
Jones, D. R. (1992) Meta-analysis of observational epidemiological studies: a review. Journal of the Royal Society of Medicine, 85, 165168.
Jorgensen, P. & Mortensen, P. B. (1992) Cause of death in reactive psychosis. Acta Psychiatrica Scandinavica, 85, 351353.
Kawachl, I. Colditz, G. A. Stampfer, M. J. et al (1993) Smoking cessation in relation to total mortality rates in women. A prospective cohort study. Annals of Internal Medicine, 119, 9921000.
Kay, D. W. K. (1962) Outcome and cause of death in mental disorders of old age. A long-term follow-up of functional and organic psychoses. Acta Psychiatrica Scandinavica, 38, 249276.
Kay, D. W. K. & Patterson, U. (1977) Manic-depressive illness: a clinical, social and genetic study. VI: Mortality. Acta Psychiatrica Scandinavica Supplementum, 269, 5560.
Keehn, R. J. Goldberg, I. D. & Beebe, G. W. (1974) Twenty-four year mortality follow-up of Army veterans with disability separations for psychoneurosis in 1944. Psychosomatic Medicine, 36, 2746.
Kendell, R. E. (1966) The fate of untreated alcoholics. Quarterly Journal of Studies on Alcohol, 27, 3041.
Kendler, K. S. (1986) A twin study of mortality in schizophrenia and neurosis. Archives of General Psychiatry, 43, 643649.
Kerr, T. A. Schapira, K. & Roth, M. (1969) The relationship between premature death and affective disorders. British Journal of Psychiatry, 115, 12771282.
Klenerman, P. Sander, J. W. & Shorvon, S. D. (1993) Mortality in patients with epilepsy: a study of patients in long term residential care. Journal of Neurology, Neurosurgery and Psychiatry, 56, 149152.
Koranyi, E. K. (1977) Fatalities in 2070 psychiatric outpatients: preventative features. Archives of General Psychiatry, 34, 11371142.
Kuperman, S. Black, D. W. & Burns, T. L. (1988) Excess mortality among formerly hospitalized child psychiatric patients. Archives of General Psychiatry, 45, 277282.
Larsen, F. W. Dahl, V. & Hallum, E. (1990) A 30 year follow-up study of a child psychiatric clientele. I: Demographic description. Acta Psychiatrica Scandinavica, 81, 3945.
Lee, A. S. & Murray, R. M. (1988) The long-term outcome of Maudsley depressives. British Journal of Psychiatry, 153, 741751.
Lesage, A. D. Trapanl, V. & Lamella, M. (1990) Excess mortality by natural causes of Italian schizophrenic patients. European Archives of Psychiatry and Neurological Sciences, 239, 361365.
Licht, R. W. Mortensen, P. B. Gouliaev, G. et al (1993) Mortality in Danish psychiatric long-stay patients, 1972–1982. Acta Psychiatrica Scandinavica, 87, 336341.
Lim, L. C. Sim, L. P. & Chlam, P. C. (1993) Mortality of public mental health patients: a Singapore experience. Australia and New Zealand Journal of Psychiatry, 27, 3641.
Lindberg, S. & Ågren, G. (1988) Mortality among male and female hospitalised alcoholics in Stockholm 1962–1983. British Journal of the Addictions, 83, 11931200.
Llndelius, R. Salum, I. & Ågren, G. (1974) Mortality among male and female alcoholic patients treated in a psychiatric unit. Acta Psychiatrica Scandinavica, 50, 612618.
Llndelius, R. & Kay, D. W. K. (1973) Some changes in the pattern of mortality in schizophrenia, in Sweden. Acta Psychiatrica Scandinavica, 49, 315323.
Lönnqvist, J. Niskanen, P. Achté, K. A. et al (1975) Self-poisoning with follow-up considerations. Suicide, 5, 3946.
Mackenzie, A. Allen, R. P. & Funderburk, F. R. (1986) Mortality and illness in male alcoholics: an 8-year follow-up. International Journal of the Addictions, 21, 865882.
Marshall, E. J. Edwards, G. & Taylor, C. (1994) Mortality in men with drinking problems: a 20-year follow-up. Addiction, 89, 12931298.
Martin, R. L. Cloninger, R. Guze, S. B. et al (1985) Mortality in a follow-up of 500 psychiatric outpatients. II: Cause-specific mortality. Archive. of General Psychiatry, 42, 5866.
Medhus, A. (1975) Mortality among female alcoholics. Scandinavian Journal of Social Medicine, 3, 111115.
Medical Research Council (1995) Topic Review. Suicide and Parasuicide. London: MRC.
Mehlum, L. (1994) Young male suicide attempters 20 years later: the suicide mortality rate. Military Medicine, 159, 138140.
Mortensen, R. B. & Juel, K. (1990) Mortality and causes of death in schizophrenic patients in Denmark. Acta Psychiatrica Scandmavica, 81, 372377.
Mortensen, R. B. & Juel, K. (1993) Mortality and causes of death in first admitted schizophrenic patients. British Journal of Psychiatry, 163, 183189.
Murphy, J. M. Monson, R. R. Olivier, D. C. et al (1987) Affective disorders and mortality: a general population study. Archives of General Psychiatry, 44, 473480.
Murphy, J. M. Monson, R. R. Olivier, D. C. et al (1989) Mortality risk and psychiatric disorders. Social Psychiatry and Psychiatric Epidemiology, 24, 134142.
Newman, S. C. & Bland, R. C. (1991a) Suicide risk varies by subtype of affective disorder. Acta Psychiatrica Scandinavica, 83, 420426.
Newman, S. C. & Bland, R. C. (1991b) Mortality in a cohort of patients with schizophrenia: a record linkage study. Canadian Journal of Psychiatry, 36, 239245.
Nilsson, A. (1995) Mortality in recurrent mood disorders during periods on and off lithium: a complete population study in 362 patients. Pharmacopsychiatry, 28, 813.
Nordentoft, M. Breum, L. Munck, L. K. et al (1993) High mortality by natural and unnatural causes: a 10 year follow up study of patients admitted to a poisoning treatment centre after suicide attempts. British Medical Journal, 306, 16371641.
Norring, C. E. A. & Sohlberg, S. S. (1993) Outcome, recovery, relapse and mortality across six years in patients with clinical eating disorders. Acta Psychiatrica Scandinavica, 87, 437444.
Norton, B. & Whalley, L. J. (1984) Mortality of a lithium-treated population. British Journal of Psychiatry, 145, 277282.
Nyman, A. K. & Jonsson, H. (1986) Patterns of self-destructive behaviour in schizophrenia. Acta Psychiatrica Scandinavica, 73, 252262.
O'Donnell, J. A. (1964) A follow-up of narcotic addicts. Mortality, relapse and abstinence. American Journal of Orthopsychiatry, 34, 948954.
O'Leary, D. A. & Lee, A. S. (1996) Seven year prognosis in depression. Mortality and readmission risk in the Nottingham ECT cohort. British Journal of Psychiatry, 169, 423429.
Ohara, K. Suzuki, Y. Sugita, T. et al (1989) Mortality among alcoholics discharged from a Japanese hospital. British Journal of the Addictions, 84, 287291.
Oppenheimer, E. Tobutt, C. Taylor, C. et al (1994) Death and survival in a cohort of heroin addicts from London clinics: a 22-year follow-up study. Addiction, 89, 12991308.
Orholm, M. Sorensen, T. I. A. Bentsen, K. et al (1985) Mortality of alcohol abusing men prospectively assessed in relation to history of abuse and degree of liver injury. Liver, 5, 253260.
Oster, J. Mikkelsen, M. & Nielsen, A. (1975) Mortality and life-table in Down's syndrome. Acta Paediatnca Scandinavica, 64, 322326.
Östman, O. (1991) Child and adolescent psychiatric patients in adulthood. Acta Psychiatrica Scandinavica, 84, 4045.
Patton, G. C. (1988) Mortality in eating disorders. Psychologica. Medicine, 18, 947951.
Pederson, A. M. Tefft, B. M. & Babiglan, H. M. (1975) Risks of mortality of suicide attempters compared with psychiatric and general populations. Suicide, 5, 145157.
Pell, S. & D'Alonzo, C. A. (1973) A five-year mortality study of alcoholics. Journal of Occupational Medicine, 15, 120125.
Perucci, C. A. Davoli, M. Rapiti, E. et al (1991) Mortality of intravenous drug users in Rome: a cohort study. American Journal of Public Health, 81, 13071310.
Pieninkeroinen, I. P. Telaklvi, T. M. & Hlllbom, M. E. (1992) Outcome in subjects with alcohol-provoked seizures. Alcoholism: Clinical and Experimental Research, 16, 955959.
Poser, W. Poser, S. & Eva-Condemarin, P. (1992) Mortality in patients with dependence on prescription drugs. Drug and Alcohol Dependence, 30, 4957.
Rantakallio, P. Läärä, E. & Koiranen, M. (1995) A 28 year follow-up of mortality among women who smoked during pregnancy. British Medical Journal, 311, 477480.
Reiter, K. (1974) Mortality and cause of death in men found to be mentally abnormal by forensic psychiatrists. Scandinavian Journal of Social Medicine, 2, 13.
Robinette, C. D. Hrubec, Z. & Fraumeni, J. F. Jr. (1979) Chronic alcoholism and subsequent mortality in World War II veterans. American Journal of Epidemiology, 109, 687700.
Rorsman, B. (1974) Mortality among psychiatric patients. Acta Psychiatrica Scandinavica, 50, 354375.
Rorsman, B. Hagnell, O. & Lanke, J. (1983) Mortality and psychiatric specialist care in the Lundby study. Age-standardized death rates in different forms of psychiatric services in a total population investigated during a 25-year period. Neuropsychobiology, 9, 28.
Rydelius, P. (1988) The development of antisocial behaviour and sudden violent death. Acta Psychiatrica Scandmavica, 77, 398403.
Saku, M. Tokudome, S. Ikeda, M. et al (1995) Mortality in psychiatric patients with a specific focus on cancer mortality associated with schizophrenia. International Journal of Epidemiology, 24, 366372.
Schmidt, W. & de Lint, J. (1972) Causes of death of alcoholics. Quarterly Journal of Studies on Alcohol, 33, 171185.
Segal, S. P. & Kotler, P. L. (1991) A ten-year perspective of mortality risk among mentally ill patients in sheltered care. Hospital and Community Psychiatry, 42, 708713.
Similä, S. von Wendt, L. & Rantakallio, P. (1986) Mortality of mentally retarded children to 17 years of age assessed in a prospective one-year birth cohort. Journal of Mental Deficiency Research, 30, 401405.
Sims, A. C. P. (1973) Importance of a high tracing-rate in long-term medical follow-up studies. Lancet, ii, 433435.
Similä, S. & Prior, P. (1978) The pattern of mortality in severe neuroses. British Journal of Psychiatry, 133, 299305.
Smith, E. M. Cloninger, C. R. & Bradford, S. (1983) Predictors of mortality in alcoholic women: a prospective follow-up study. Alcoholism. Clinical and Experimental Research, 7, 237243.
Stewart, L. A. & Parmar, M. K. B. (1993) Metaanalysis of the literature or of individual patient data: is there a difference. Lancet, 341, 418422.
Ström, J. Thisted, B. Krantz, T. et al (1986) Self poisoning treated in an ICU: drug pattern, acute mortality and short-term survival. Acta Anaesthesiologica Scandinavica, 30, 148153.
Sturt, E. (1983) Mortality in a cohort of long-term users of community psychiatric services. Psychological Medicine, 13, 441446.
Surtees, P. G. & Barkley, C. (1994) Future imperfect: the long-term outcome of depression. British Journal of Psychiatry, 164, 327341.
Thompson, S. G. & Pocock, S. J. (1991) Can metaanalyses be trusted. Lancet, 338, 11271130.
Thorarinsson, A. A. (1979) Mortality among men alcoholics in Iceland. 1951–74. Journal of Studies onAlcohol, 40, 704718.
Tsuang, M. T. Woolson, R. F. & Fleming, J. A. (1980) Causes of death in schizophrenia and manic-depression. British Journal of Psychiatry, 136, 239242.
Tunving, K. (1988) Fatal outcome in drug addiction. Acta Psychiatrica Scandinavica, 77, 551566.
Tverdal, A. Thelle, D. Stensvold, I. et al (1993) Mortality in relation to smoking history: 13 years' follow-up of 68,000 Norwegian men and women 35–49 years. Journal of Clinical Epidemiology, 46, 475487.
Vaillant, G. E. Clark, W. Cyrus, C. et al (1983) Prospective study of alcoholism treatment: eight-year follow-up. American Journal of Medicine, 75, 455463.
Vestergaard, P. & Aagaard, J. (1991) Five-year mortality in lithium-treated manic-depressive patients. Journal of Affective Disorders, 21, 3338.
Weekke, A. & Vaeth, M. (1986) Excess mortality of bipolar and unipolar manic-depressive patients. Journal of Affective Disorders, II, 227234.
Weekke, A. Juel, K. & Vaeth, M. (1987) Cardiovascular death and manic-depressive psychosis. Journal of Affective Disorders, 13, 287292.
Wells, J. E. & Walker, N. D. (1990) Mortality in a follow-up study of 616 alcoholics admitted to an inpatient alcoholism clinic 1972–76. New Zealand Medical Journal, 103, 13.
Wheeler, E. O. White, P. D. Reed, E. W. et al (1950) Neurocirculatory asthenia (anxiety neurosis, effort syndrome, neurasthenia): a twenty year follow-up study of one hundred and seventy-three patients. Journal of the American Medical Association, 142, 878889.
White, S. J. McLean, A. E. M. & Howland, C. (1979) Anticonvulsant drugs and cancer. A cohort study in patients with severe epilepsy. Lancet, ii, 458461.
Whitehead, A. & Hunt, A. (1982) Elderly psychiatric patients: a five-year prospective study. Psychological Medicine, 12, 149157.
Whitiock, F. A. & Siskind, M. (1979) Depression and cancer: a follow-up study. Psychological Medicine, 9, 747752.
World Health Organization (years up to and including 1961) Annual Epidemiological and Vital Statistics, Geneva: WHO.
World Health Organization (1962 and years following)World Health Statistics Annual. Geneva: WHO.
World Health Organization (1977) International Classification of Diseases, 9th Revision (ICD-9). Geneva: WHO.
Zaccarelli, M. Gattari, P. Rezza, G. et al (1994) Impact of HIV infection on non-AIDS mortality among Italian injecting drug users. AIDS, 8, 345350.
Zilber, N. Schufman, N. & Lerner, Y. (1989) Mortality among psychiatric patients — the groups at risk. Acta Psychiatrica Scandmavica, 79, 248256.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Excess mortality of mental disorder

  • Clare Harris (a1) and Brian Barraclough (a1)
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *